3527 
15 B8 



SOME 



VITAL STATISTICS 



OF THE 



CITY OiLWILMINGTON, 




v 



\ 




BY 



L. P. BUSH. M. D. 



Read before the Delaware State Medical Society, June. 1877. 



LIBRARY OF THE 

UNITED STATES BUREAU OF EDUCATION 

— » ♦ « 

Division. 

Shelf. JVo 

PRESENTED BY 







w^V 



cr 



SOME VITAL STATISTICS 

OF THE 

CITY OF WILMINGTON. 

By L. P. BUSH, M. D. 
Read before the Delaware State Medical Society, June, 1877. 

^ v 



v The object of this paper is to present to the Society some vital 

statistics o** the City of Wilmington, as drawn from the Registry of 
Deaths in that city. Unable to get time to analyze the whole Registra- 
tion. I have taken several of the principal causes of mortality there, as 
follows: — Typhoid Fever, Pneumonia, Diptheria, Cholera Infantum, 
Marasmus and Inanition. Of these I have taken the record for the 
past five years, 1872 to 1877. 

It is not necessary for me to describe the topography of the City 
of Wilmington — but I may state that west of Walnut street the city is 
well drained, being high and rolling ; but east of that street it is nearly 
flat. That eastern section contains about one third of the population 
of the city. The whole city is supplied with Brandywine water, e 
Brownville, which has been recently brought within the city limits. 
What was called McDowellville, has been supplied with the Brandy- 
wine water within four years — but a considerable portion of it (j{) 
still use water from wells. 

The population of Wilmington, according to the U. S. census for 
5870, was 30,841, of which 27,630 were whites, and 3,: 1 colored. 



Estimating the increase since 1870, by the number of houses 
erected, and at the rate of eleven persons to two houses, we have 
38,000 persons at the beginning of the present year ; and an average 
of the last five years would be 34,000. 

Of this population there was the following number of deaths — • 
January to January : 

1872. 1873. I 874- 1875. 1876. 



Whites. 604 543 570 721 529 

Colored, 145 126 123 135 132 



Total, 749 669 693 856 661 

An annual average of 725. 

This number includes the deaths in the Almshouse — -a large pro- 
portion of whose inmates come from Wilmington. The proportion of 
deaths to population in those years 1 in 47 inhabitants ; or 2.10 per 
cent, of the whole population. 

The deaths resulting from Typhoid Fever were as follows : 
From March, 1872, to February, 1873, inclusive, 32 deaths. 
From " 1873, to " 1874, " 26 

From " 1874, to " 1875, " ! 5 
From " 1875, to " l8 7 6 > " l8 

From " 1876, to " ^77, " 17 

In all, 108 deaths. Of these deaths 

From 1872 to 1873, 28 were white, 4 colored, 
From 1873 t0 l8 74, 22 " white, 4 colored, 
From 1874 to 1875, 11 " white, 4 colored, 
From 1875 to l8 76, 15 " white, 3 colored, 
From 1876 to 1877, 14 " white, 3 colored. 
Of these cases there were definitely reported as follows ; classed by 
wards : 



I 1 


2 

4 


! 3 

|io 


4 

5 


1 5 

|I3 


6 
4 


1 7 


8 


9 Wards. 


27 


1 " 


8 


6 ] 87 Deaths. 



* Of the deaths not included in this estimate by wards, 3 occurred 
in S. E. Wilmington and 4 in Brownsville, and the remainder were not 
definitely reported. Indeed there is reason to believe that the mortu- 

*Note. Discrepancies 111 figures occur from failure to report color. 



ary record of the city is not as full as it should be ; a defect which will 
be remedied in future by the ordinance recently passed by the City 
Council, regarding this point. 

It would be impracticable without more correct statistics of the 
population of the several wards than I possess, to make a satisfactory 
analysis of the relative proportion of deaths in the respective wards; 
and even with that information, it would be difficult to account for the 
disproportion which here appears; especially between the First and 
Second Wards. 

It may be noted that the population of the First Ward is about 
twice as great as that of the Second ; but the First Ward has the ad- 
vantage of the Second in that many of the houses are new and the 
situation generally more elevated and dry, with better cellar drainage, 
and less compactness of dwellings in the new portion, and a soil com- 
posed mainly of gravel. 

It will be perceived from the above statement that the annual 
mortality of the white population from Typhoid Fever in Wilmington, 
estimating the average number of that class at 30,000, was during those 
five years, 1 in 1666.66, and of the colored people 1 in n n. 

The proportion of the colored and white population is as 1 to 7.5 ; 
and the proportion of deaths, 1 colored to 4. 5 white > showing a larger 
mortality among the former; a' difference which ordinary hygienic 
conditions would serve to explain. 

Of the total mortality from this fever an average of those five years 
gives 1 death to 1569 persons. For the year 1875, the proportion is 
t to 1 888 ;• and that of Philadelphia for the same year, 1 in t 9 o 5 . In 
the epidemic ot Typhoid Fever which prevailed in Wilmington from 
October, 1847 to i8 5 i, inclusive, the whole mortality was 89 ; and as 
the population at that time was about 12,000, the deaths were as 1 in 

C40 inhabitants. 

I may here state the annual number of deaths from this disease in 
the city proper, for the seven years, preceding 1872, were as follows : 
!86 5 . 1866. 1867. 1868. 1869. 1870. 1S71. 

14 17- l 3- lI " r ^" 

'it will appear from 'this statement that notwithstanding the great 
increase of our population since 1865, with the exception of the years 
1872 and '73, the number of deaths from this disease had scarcely 



increased. Whatever may be the causes of this fever, it thus appears 
that during the long period from 1865 to 1877, tne y have been less and 
less operative among our people; or at least, less fatal. 

It would seem from the above statistics, that the cause of this fever 
is not inherent in any section of the city, but spreads throughout ; and 
hence the cause or causes must be general. 

In the year 1838, some cases of Typhoid Fever occurred near the 
Brandywine Springs, four miles west of Wilmington : from which point 
the disease spread north and west several miles, through a high, well 
drained and cultivated country, supplied by springs and wells ; chiefly 
the latter. It seemed in part to have been extended by contagion, but 
not exclusively. Nor has a sufficient explanation of that epidemic yet 
been offered. If we refer it to the impurity or contamination of the 
drinking water by the drainage from cess-pools, it may be replied that 
the rain-fall from 1835 to 1840 was 49 inches, annuai average, nearly 
8 inches more annually than for the next five years, and 4^ inches 
more than from 1845 t0 ^50; so that it is evident that the concentra- 
tion of the drainage impurities in the water must have been less in the 
years of the prevalence of the disease than for ten years following, 
when it had in a great measure subsided. No such visitation has been 
experienced in that section, since that time. 

And here, I would urge upon the members of the Society, the im- 
portance of reporting to the Society's committee for the coming year, 
the number of cases of this disease which comes under their observation, 
and also the months of their occurrence, ages, occupation, color, sex, 
cause as far as ascertained, together with the other facts requested by 
the committee. This would be one step towards utilizing our experi- 
ence for public benefit, and towards resolving the yet unsolved problem 
of the chief cause or causes of this disease. Physicians in the country, 
and in towns, unsupplied by public reservoirs, could add greatly to the 
knowledge of the causes, and mode of prevention of this disease, so 
much and so justly dreaded. 

If it be true, that one chief cause of this, and other Zymotic 
diseases is to be found in the impurities of the water we drink, how 
important is it that we should know it, in order to control the cause. 
We have, until recently, sought for its origin chiefly, if not exclusively 
in the impurities of the atmosphere, within and without doors; in per- 
sonal uncleanliness ; over-work, whether of body or mind, and other 



5 

li' e agencies. And these causes cannot be ignored ; for it must be 
apparent that as the winter months advance, and the houses of the 
people are more and more closed, and ventilation becomes less and less 
a fact; when the chambers of the sleeping population are shut in to 
keep out the cold, and with the same effectiveness keeps out the air : 
when multitudes go unwashed during the whole winter, sending off 
from their bodies heavy and pernicious exhalations, we must be satisfied 
that these factors are not without their importance in the production of 
these diseases. It had doubtless been long an insalvable riddle, to 
many other physicians besides myself, that the prevalence of Typhoid 
Fever did not at all correspond with the existence of the above men- 
tioned conditions, so long considered as the main remote causes of it. 
I well remember, that on one of the last visits of the late Dr. Samuel 
Jackson, of the University of Pennsylvania, to this city, a man who 
had all his life been studying this disease, and wiio was among the very 
first to recognize its existence in Philadelphia, he remarked, that he was 
often utterly at a loss to specify a satisfactory cause or causes of this 
disease. 

In view of these considerations, we may feel ourselves prepared to 
consider the present theory, which yearly gains strength, that one great 
cause of Typhoid Fever may be found as much in what enters our 
stomach as our lun^s. 

Since the attention of physicians has been called to this subject, 
numerous facts have been brought forward which show the great power 
for evil that is exercised by the water we drink. And here we find 
something to help us understand the existence of this fever in high and 
well-drained districts, inhabited by thrifty and wealthy farmers, whose 
fields and barns show every evidence of high agricultural cultivation. 
The drinking water of those farms is usually drawn from wells sunk 
long before the subject of hygiene occupied the thoughts even of phy- 
sicians, except in a very general way. From the inconvenience which 
arises from privies when placed too remotely from the house, they often 
occupy a situation very near the pumps, and hence render the water 
liable to be impregnated with the drainage from the cess-pool. The 
distance to which this percolation extends, varies greatly, being depend- 
ant upon the nature of the soil, and the relative depth and situation of 
wells. From too to 200 feet, under favorable circumstances, has the 
drainage from a privy been ascertained to extend, by showing itself in 



the drinking well. Besides the unpleasant impression produced by such 
facts, the danger to health and life is far more serious than is usually 
supposed or believed. It is especially so after long droughts, when the 
water in the wells becomes low, that the consequences of these impuri- 
ties show themselves. At other times, when the flow of water, and con- 
sequent dilution are great, but little inconvenience may be experienced, 
for long periods, or not at all. But there is a point ot saturation by 
this septic matter, which is sometimes reached at length, and then the 
anti-hygienic results develop themselves unexpectedly, and unaccount- 
ably, if not carefully investigated. 

Enough perhaps has been said to stimulate attention to this sub- 
ject, in the hope that we may be led to examine further into the evi- 
dences of this agent as one cause of Typhoid fever and other zymotic 
diseases. The only instrumentality by which this, and kindred sub- 
jects can be established if true, or discredited if false, is that of Phy- 
sicians. It is and always has been our province to do a great deal for 
the community for which we receive neither thanks or reward, except 
we have it in the consciousness of doing good. Under the influence 
of ignorance upon these subjects of health and hygiene, and of preju- 
dice against them, as at variance with the teachings of their limited 
and defective observation and experience, we need not expect much 
assistance from the people generally, but rather opposition ; until after 
repeated and long continued efforts, and the demonstration of facts, 
to the meaning of which their eyes have been opened, they are brought 
to appreciate that there may be value, and can at least be no harm in 
encouraging the dissemination of these truths. At the last meeting of 
our Legislature the Committee appointed by the American Medical Asso- 
ciation, in conjunction with a like Committee from this Society, pre- 
pared a bill for the Registration of Births, Marriages and Deaths, and 
also one for the establishment of a State Board of Health ; but as an 
illustration of what has just been said, that body could not see the 
necessity for their enactment, and they were indefinitely postponed. 
It is to be hoped that when our State Representatives convene again 
they may take a more favorable view of the matter and that these bills 
may become a law. But in order to do this we must show our appre- 
ciation of the value of these subjects by our endeavors to impress them 
upon the minds of our Representatives and the people, whenever op- 
portunity offers, and it must be made to appear to them that in this- 



matter it is not Physicians that art? to be benefitted, but the people, 
whose interests they, the Legislature, are elected to maintain ; and 
that not in subjects political and material only, but also in those which 
pertain to their comfort and their very existence. It is very true that 
the faithful execution of such laws as these involve no inconsiderable 
amount of time and inconvenience to Physicians— but as before said, 
this is a duty incumbent upon us, and inherent in our profession, and 
which we are bound to be ready to perform. Thus acting, we show 
ourselves to be worthy successors of that noble army of philanthro- 
pists, who have, from the days of Hippocrases spent time, ease, and 
life in the cause of humanity, by labouring to evolve light from dark- 
ness, truth from error, and to diminish the amount of suffering entailed 
upon man by reason of transgression of the laws of his physical and 
moral nature, which are the laws of God. 

The next disease the statistics of which will be presented is Dlp- 
theria. This is a disease whose presence in Wilmington is bounded by 
the year i860, when the first case was reported to the Register of 
Deaths. From the year 1847, wnen the Registry was commenced, to 
the year i860, but nine deaths were reported from throat disease, none 
of them under the name of Diptheria. From i86oto 1865, inclusive, 
there occurred 71 deaths from this disease, and for the succeeding six 
years the deaths were 46. 

i860. 1861. 1862. i36 3 . 1S64. 1865. 



20. 



18. o 20. 4. 9. 
1866. 1867. 1868. 1869. 1870. 1871 



7. 8. 10. 7. 



8. 6. 



During the five years from march, 1872, to March, 1877, the 
number of deaths from this disease as reported, was 61, of which 52 
were whites and 9 colored persons, tabulated as follows, by Wards : 
1 1 ^ I 3 1 4 [ 7TM~7 1 8 1 9 "Wards. 



„ "j 5 1 9 J 3 I 11 J 3 I 1 J 16 1 1 Deaths. 



The increase of this Zymotic disease since the year i860, before 
which time it was almost unknown, shows that the causes producing it 
must be more active than previously. What are those causes ? There 
is an increase of population, two and a half times, and a consequent 



increase of compactedness ; in i860 the population being 21,508; 
now 38,000 ; but" on the contrary, with the increase of population 
came an increase of warm and dry dwellings, small and close together 
it is true, but attended with an improvement in the means and mode 
of living. 

There has been also an increase of manufactures along the Brandy- 
wine by several hundred per cent, and a consequent increase of refuse 
maierials thrown into the water since i860. But by the analysis of 
Messrs. Booth and Garrett, and of Prof. Aikin, in 1863, and that of 
Prof. Wolf, of Delaware College, this year, the quantity of organic 
and saline matter seem to be about the same in character and quantity 
then as now. There has been also a great improvement in the hy- 
geinic condition of the city by street paving, and by the filling up of 
ponds and sloughs in certain sections. 

If there is a change in any respect unfavorable to the health of 
the city it would seem to be in the water we drink. Whatever stress 
may be laid upon the impurities from the factories, it is quadrupled by 
those which are swept into the Brandywine by every heavy rainfall 
from the hillsides and valleys, consisting of earthy and excrementitious 
substances. 

One important fact maybe observed. During the years 1847 to 
1851, when the typhoid fever prevailed as above remarked, to an 
alarming extent among us, almost no deaths from throat disease are 
recorded, showing that the causes of these diseases are not identical. 
This conclusion also seems justifiable from the additional fact that the 
mortuary record of the two diseases here, after the establishment of 
the Diptheria among us, bear no especial relation to each other. 

The proportion of colored and white cases is 9 of the former to 
52 of the latter, which is nearly : to 6. This is a disease which chief- 
ly affects children under 10 years of age, and is most prevalent in the 
cold months. In 1873 no death occurred from June to October; in 
1S75 an d 1876 none from March to September, inclusive. 

Of all the Acute Diseases, Cholera Infantum stands at the head of 
the list of mortality. Originating in the high thermometrical range of 
June, July and August, it hurries through its devastating course, and 
leaves behind it a multitude of slain innocents. No sex or station of 
life is exempt from its power : but its chief spoils are among the child- 
ren of poverty and ignorance. In the same five years, during the 



9 



months of June, July, August and September, were 168 deaths, an 
annual average of 33 3-5, of which 143 where whites and 25 colored. 
Of these, 102 died in July — a fearful mortality when we consider that 
these subjects come chiefly from that portion of the population under 
three years of age. 

The proportion in these cases of colored to white, is 1 to 5.7 — 
showing a greater mortality in the former than in the latter ; when 
compared with Typhoid Fever and Diptheria. 

The relative mortality by wards is as follows . 



*. 1 


2 


3 1 


4 


5 


6 i 


7 1 


8 1 


9 Wards. 


39 1 


7 


20 | 


'5 , 


21 


^3 1 


9 


| 2 o 


4 Deaths. 



Besides these, were a number of cases residence not reported. 

From the year i860 to 1872, inclusive, the deaths were as follows 
from Cholera Infantum : 
i860. 1861. 1862. 1863. 1864. 1S65. 1866. 



22. 
1867. 



1868. 



12. 
1869. 



14* 

1870. 



21 . 
1871. 



19. 

1872. 



15. 32. 26. 23. 28. 43. 

Of Croup, the following is the simple record of deaths 



Months 


a 


Feb. 
March. 


ft 

<! 


2 


<6 

5 


1 — 1 




ft 




O 


> 




6 

Q 




1871. | 1 | 1 


1 | j j i 1 


| | 


| 4 


*&7 2 - | j 3 | 3 


| | | | 2 | 3 | 3 | 1 


2 | 17 


1873. | 1 | 1 


2 | oj 2 | oj 1 { 2 | | 4 


1 1 13 


1874. | 1 1 2 j 


I | 3 | O | OJ T 1 O | 6 | 2 


2 | 18 


1875- 3 1 3 1 1 1 ° 


2 | 1 | 1 | 2 | | 1 | | 1 | 15 


1876. 


'1 


3| 3 


O 


OJ O 1 1 I 1 o| 2 1 2 | O | 12 



Of Marasmus and Inanition the same five years give a result of 
153 deaths — or 30 3-5 annually, of which 122 were whites, and 31 
colored. Showing a greater proportion of blacks (viz: 1 in 4.) than 
in Cholera Infantum. 

Of Pneumonia we find a mortality of 91 in those 5 years — 60 

whites and 31 colored. In the N. E. section, 23; N. W., 9; S. E., 

14; S. W., 19. These figures show wheie the danger to the sons of 

Africa come from — not so much from his stomach and bowels as from 

2 



10 



his lungs, the proportion of deaths from this disease of white to col- 
ored being scarcely 2 to i. 

This is an appropriate remark, for while, as a class, the colored 
people are worse housed and fed, and less cleanly than white day labo- 
rers generally are, yet these causes should operate equally upon them 
in the production of Cholera Morbus, as in Phthisis and Pneumonia. 
But as such is not the case, we say that these facts go to prove that 
that class are peculiarly subject, in a fatal degree, to diseases of the 
respiratory organs. 

The only remaining disease to be mentioned is Phthisis. The 
whole mortality from this disease in the same years was 418 — of which 
325 were white, and 93 colored; the proportion being 3^ of the 
former to 1 of the latter ; and the ratio of deaths to population 1 in 
81 persons. In the successive years, commencing with 1872, the deaths 
from this cause, were 75, 87, 70, 96, and 90; a mean annual mortality 
of 83.60 ; which is at the rate of 10.75 P er cent - of the whole mortali- 
ty. In this, and in all other reports of special diseases here made r 
the deaths in the Almshouse are not included. The deaths per cent, 
from Phthisis to the whole mortality of the following places, is as fol- 
lows : 

Rome, 9 per cent. 

Naples, 8 

New York, 1 866-' 70, 13.7 
Brooklyn, 1868, . 14.84 
San Francisco, 1877, 1 3-5° 
Philadelphia, " 13.16 
Wilmington, '72-' 77, 10.75 
Boston, . . . . 14.17 

These are but a few of the results which might be obtained from a 
thorough analysis of the mortuary record of our city. As the first at- 
tempt however, to condense them it will form a foundation for some 
more patient worker in these statistics ; while we await the time when 
the municipal authorities will have learned the importance to the com- 
munity and to the city, of a complete annual report of its vital statis- 
tics, and will provide a competent person to prepare such report. 

The mortality of the city from 1850 to 1876 was as follows 



Paris, 


13.4 per 


cent. 


Belgium, 


16 


t i 


(< 


England, 


12 


i i 


1 i 


Frankford, 


2 5 


" 


ti 


Vienna, . 


20 


a 


i ( 


Berlin, . 


!75 


1 t 


I I 


Geneva. 


9-7 


is 


it 


Turin, 


9 


t t 


It 


Venice, . 


9 


it 


It 



II 



Whole No. 


W: 


Col. 




Whole No. 


W. 


Col. 


296 


224 


72 


1864. 


478 


413 


65 


35i 


289 


62 


1865. 


469 


4c 2 


67 


355 


265 


90 


1866. 


439 


346 


93 


358 


273 


85 


1867. 


45 6 


383 


73 


420 


318 


102 


1868. 


538 


470 


68 


422 


339 


83 


1869. 


494 


424 


70 


461 


37r 


90 


1870. 


5 2 4 


45 6 


68 


5io 


425 


85 


1871, 


534 


434 


100 


423 


320 


103 


1872. 


761 


616 


145 


453 


362 


9 1 


1873. 


663 


543 


120 


434 


338 


96 


1874. 


6 93 


57o 


123 


421 


343 


78 


1875- 


75 6 


721 


x 35 


472 


39 6 


76 


1876. 


661 


5 2 9 


132 


489 


412 


77 











1850. 
1851. 
1852. 

1853- 
1854. 

1855- 

1856. 

1857. 
1858. 
1859. 
i860. 
1861. 
1862. 

1863. 

Previously to 1865 the number of interments from abroad were 
included in the death rate by an oversight of the several Registrars. 
The number varied from none to 1 2 burials per month. 

From the Vital Report of the City of Richmond, for 1876, it ap- 
pears that the population was, of white people 42,830, of colored 
people 32,170. 

Of the white population there was one birth to 40.36. 
" " colored " << << one " " 36.72. 

Of the white " " <• one death " 57.57. 

" " colored " ". " one " " 35-54- 

That the whites gained by births over deaths, 317 

That the colored lost by deaths over births, 29 

The colored people form so large an item in the population of 
both Richmond and Wilmington, (though far greater in the former 
than the latter) that a fact such as that just mentioned is interesting 
and important ; but from the want of a record of births in Wilmington, 
it is impossible to make any approximation to a true estimate of the 
gains or losses. 

Hence we see the importance of a record of births ; and not of 
births only, but also of marriages. It is impossible without all of these 
to ascertain the inherent vitality and prosperity of any community. 
We know that our population is increasing ; and that knowledge was 
perhaps sufficient a hundred years ago ; but it is a fact unworthy of an 
intelligent community that it is satisfied with the gross knowledge of 



12 

an increase, without knowing bow, or whence it comes ; and whether 
the lives of its citizens could not be prolonged, and thus the strength 
and prosperity of the people be greatly increased. Independent of the 
personal affliction which death induces, it is often an irreparable loss 
to the community, when a person fitted by education and experience 
for usefulness, is hurried out of the world by preventable causes, which, 
however unseen they may be, are none the less potent for evil. Large 
sums of money are expended annually by the public to fit our children 
for citizenship ; is it wise to overlook the careful investigation of causes 
which will shorten their lives, and deprive the public of their services ? 
These remarks are appropriate not to Wilmington merely, — for 
that city has a Board of Health, long established, but not without ma- 
terial defects, and the Vital Reports are insufficient as just stated, — but 
the whole State has need of a waking up to the importance of an in- 
telligent supervision of the interests pertaining to the health of her 
citizens. Important as the political concerns of a State may be, and 
are, they are not the only public interest to which the people should 
devote "their attention. 

Assuming that a record of births should be kept, and that it will 
be kept, and the sooner the better, the following is suggested as the 
most feasible plan. The points to be ascertained are as follows : Date 
of birth, sex, color, alive or still-born, name, name and nation of 
father, ditto of mother. 

The proper person to obtain thes^ facts is the Assessor, to whose 
labors it would add but little, and who could readily get all these data 
even to the name, which the Physician could seldom obtain at the time 
of birth. Besides, many children are born when no Physician is 
present, nor even a midwife, and consequently no report would be 
made, whereas all these could be gathered up by the Assessor. 

A dime or less for each case would compensate the officer for his 
trouble ; would add very little to the expenses of the city or county, 
and would greatly enhance the knowledge as well as the credit of the 
community. 



